Smoking new focus of pediatric practice

A recent survey conducted at Goldsboro Pediatrics produced a staggering statistic -- 25 percent of its patients are exposed to smoke in the home or car.

The practice caters to a younger demographic, said Dr. Dave Tayloe, founder, but sometimes that requires treating, or at least educating, others the child is exposed to and addressing potential health risks.

Smoking, even secondhand, is a prime example, he said.

"Smoking is going to cause cancer and emphysema and create problems with asthma for children," he said.

Several years ago, the American Academy of Pediatrics established a network called PROS, or Pediatric Research in Office Settings, of which the local practice became a member. A grant for office-based research was used to discern what happens with families and children and if certain interventions make a difference.

An outgrowth of that is a project called CEASE, designed to identify families where one or more members smoke tobacco products, and to link them with Quitline N.C. for education and support.

"There's been a pretty big effort at the academy (on this)," he said. "We were recruited as one of a number of practices participating in the project across the country. I agreed to be the coordinator of this for Goldsboro Pediatrics."

An interviewer conducted the survey at the practice, talking with parents at the time of discharge until she had collected 105 families to participate.

"It was two weeks standing around at our checkout and taking people that wanted to talk to her," explained Tayloe. "On the flip side, we the providers have established a system whenever somebody says they smoke, where we try to ask about that at every visit.

"We're trying to rev up our efforts to ask about it."

The effort has involved asking questions about smoking habits, linking them with coaching resources and even writing prescriptions for adult or juvenile smokers to secure nicotine patches or gum, and arranging follow-up visits to keep them on track.

"Our real goal is to connect these people with the Quitline moving forward," Tayloe said. "It's really been exciting to hear people talk about it.

"You run into the hard-core smoker who says, 'Leave me alone, I'm going to keep smoking.' That's a very rare response -- in many cases, they say they have tried and tried to quit."

Professional smoking cessation coaches at Quitline teach smokers effective tools, while scientific measures like the nicotine patch and gum also aid in slowly weaning them off the addiction to nicotine. But admittedly, Tayloe said, the patch and gum can be expensive, which is where his practice comes in.

In many cases, insurance can cover such incidentals, Tayloe said, and physicians are able to write prescriptions for the patch or the nicotine gum.

The goal of recruiting 100 patients was met quickly, he pointed out.

In fact, it even drew attention among its counterparts.

"We set a record for the national program (one day) when we enrolled 17 new smokers in the Quitline program," he said. "We got a call saying no practice has ever enrolled 17 families in one day."

In addition to the Quitline option, the practice will follow participants for a year through electronic records and face-to-face time during office visits.

"There's a lot of follow-up work that we can do," he said. "I think there's plenty of good data there that if your doctor talks to you about smoking, that's powerful."

Currently, the Goldsboro Pediatrics office is the only one promoting the program, he added, but anticipates the satellite locations in LaGrange, Mount Olive and Princeton will soon implement it as well.

Tayloe said he is confident the benefits of the program will be far-reaching -- not only to the smoker but for family members and others who might be exposed to the habit.

"It really turns into a really big quality improvement project for the practice," he said. "We're the only practice in the county for pediatrics. We really touch a lot of Wayne County families in this area of smoking cessation.

"I think his project is mostly likely going to have countywide impact if we can keep it going."